5 Things No One Tells You About Botox

Botox, the wrinkle-smoothing neurotoxin millions count on to look younger than their years, celebrated a birthday of its own last month: the big 1-5. Since the injectable’s inception, we’ve reported on its myriad uses, tracked the evolution of its aesthetic, and debunked some dogged myths—but only recently did we experience its magic for ourselves. And getting hands-on with the country’s most popular cosmetic treatment not only erased our deepening frown lines, it broadened our understanding of the wonder drug. (Turns out, you don’t know Bo until you try it.) Here, five surprising facts about the anti-aging icon.

1. It feels a little weird—but not in a bad way.

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In the first few days following our inaugural dose, we sensed a vague sort of dullness, or heaviness, across our brow. “An accurate description,” says Robert Anolik, a cosmetic dermatologist in New York City. With Botox, “we’re limiting the muscle contractions that lead to folds, so yes, it can feel funny in the beginning, because you’re not able to move muscles that would normally contract on command,” he explains. While it can take some getting used to, it’s totally normal, and over time, those muscles will learn not to make the exaggerated expressions that etch in crinkles and crevices.

2. It takes a few days to see the full effect.

This one, we probably did know, but temporarily forgot (that happens when you’re 40). Anyway, a few hours post-jab, while making scrunchy faces in the mirror, we noticed…nothing. Our 11 lines still snarled angrily mid-frown. And when we raised our brows, there was that familiar accordion appearance. But the next day, we could only form one side of the 11; by day three, it had faded completely. (Our forehead still bunched a bit, because as Anolik notes, “this area should never be frozen.” Using tiny amounts of Botox, very strategically, minimizes lines without looking artificial or crazy.) While “everyone is different, Botox usually takes full effect after three to seven days,” Anolik says. The result lasts a glorious three to four months, waning gradually. But you’ll want to re-up before it wears off entirely to keep skin as smooth as possible.

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3. Botox can trigger headaches.

But, wait, you’re thinking, doesn’t Botox relieve headaches? Yep. It is proven to do so when injected into certain areas. “But, paradoxically, I have a number of patients who get headaches the first time they try Botox,” says Whitney Bowe, a cosmetic dermatologist in New York City. If pain strikes the same day, it’s “usually related to the stress of getting the injections, as there’s always a bit of anxiety for first-timers, and this can trigger a tension headache,” she says. Delayed headaches—those coming on seven to 14 days post-shot—typically arise from one fighting that new numbish feeling we describe above. “Botox blunts the expressions that create wrinkles, so if you keep trying to frown hard, raise your brows high in surprise, or smile so big your eyes scrunch up, you can get a headache,” Bowe says. “But 99.9 percent of the time, these headaches, whatever the cause, never reoccur—they’re one and done.” While it’s important to avoid pain-relievers, like Advil, aspirin, Aleve, and ibuprofen in the week prior to injections—as they can contribute to bruising—you’re safe to pop them after.

4. “No downtime” doesn’t necessarily mean no bruises.

Anytime a needle pierces skin, there’s the potential for black-and-blues. “Don’t schedule your appointment the day before an important meeting or party,” says Anolik. “You want to give Botox, or any injectable, three to seven days to really settle in.”

5. Icing skin after injections won’t help—and could hurt.

If you do get a bruise or blotch, reach for anti-inflammatory arnica gel and a good opaque concealer—not ice. “Mouse studies have shown that cold temperatures actually inhibit the uptake of Botox, curtailing its effect,” says Bowe. And with a ballpark price of $500, you won’t want to shortchange your shot.

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